Perforation rate of intraoral barriers for direct digital radiography

Knowledge and Practice of Kerman Dentists about Infection Control in Digital Radiography

STATEMENT OF THE PROBLEM

Infection control is essential for a safe clinical environment during patients' treatment in dentistry. Transmission of the infection can occur due to contact with patients' saliva and blood in radiology clinics.

PURPOSE

The purpose of this study was to investigate the knowledge and practice of dentists in Kerman about infection control in digital radiology.

MATERIALS AND METHOD

This cross-sectional study was conducted on 162 dentists who worked either in private office or clinic or both. The samples were selected through simple sampling method. Data were collected through demographic data, and valid and reliable questionnaire consisted of 7 questions about knowledge and 12 questions about practice on infection control in digital radiology. Data were analyzed in SPSS 26 software using T, ANOVA, and linear regression tests. The p value was considered at 0.05% significant level.

RESULTS

86(53.1%) of participants were men and 76 (46.9%) were female. The mean age of participants and work experience were 36.32±8.88 and 11.03±8.53 years, respectively. The mean and standard deviation of knowledge, practice, and total were 5.20±1.26, 7.98±2.00, and 13.22±2.72, respectively. There was a positive significant correlation between knowledge with age of participants (p= 0.009). There was also a direct significant correlation between knowledge and practice with work experience (p= 0.045 and p= 0.01 respectively).

CONCLUSION

Knowledge and practice of dentists in Kerman about infection control in digital radiology were good and medium respectively. However, there was a direct significant correlation between knowledge and practice of dentists. Knowledge and practice scores in dentists who worked in private office were significantly better than those who worked only in clinics.

"New Normal" Radiology

COVID-19, the most recent and globally impactful zoonotic viral pandemic in the last 20 years, has now entered its third year. As the global dental profession returns to providing as full a range of services as possible, in addition to embedding the new infection-control processes that were developed for this pandemic, it should also take full advantage of digital conventional radiology (intraoral, extraoral, and panoramic radiography) and cone-beam computed tomography. Regardless of vaccinations, new or yet-to-manifest variants, and testing, some dentists may be working in communities where the asymptomatic but potentially infectious patient poses a real risk. This needs to be met with not only the whole COVID-19 panoply the dentist is already too familiar with but also the need to minimise aerosol generation production by dental radiography. A flowchart and a table that compares the attributes of the above modalities are included.

Effect of enveloping and disinfection methods on artefact formation on enveloped PSP plate images

Objectives

To investigate the artefacts caused by different disinfection and protection methods that can be used for infection control of photostimulable phosphor (PSP) plates.

Methods

The plates that were enveloped with single or double envelopes were sprayed with an alcohol-containing solution or wiped with an alcohol-containing tissue. Four PSP groups with two plates in each group were formed (A = wiping single envelope, B = wiping double envelopes, C = spraying onto single envelope, and D = spraying onto double envelopes). Any artefacts (1 = no artefact, 2 = presence of artefact less than 0.5 cm wide, and 3 = presence of artefact larger than 0.5 cm wide) on the 12 acquired images were evaluated.

Results

Artefacts (score-3) occurred on the images of Group C-2 PSP plate after the 3rd exposure. According to the Kruskal–Wallis test the difference between the artefact score of the four methods was found significant. Post-hoc comparisons showed the Group C artefact scores were higher than the others and the difference was significant. The total time of enveloping and disinfection processes for groups was; A = 6.30 min, B = 7.58 min, C = 5.48 min, and D = 7.14 min.

Conclusions

Regardless of the number of envelopes, wiping with a tissue was less likely to cause artefacts, while spraying was reliable only when double envelopes were used. However, using a tissue and double envelopes, which are less risky in terms of artefact, causes time loss, difficulty in manipulation, environmental pollution and high cost.

Guidelines for oral and maxillofacial imaging: COVID-19 considerations

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus causing the current coronavirus disease 2019 (COVID-19) pandemic, is not only highly infectious but can induce serious outcomes in vulnerable individuals including dental patients and dental health care personnel (DHCPs). Responses to COVID-19 have been published by the Centers for Disease Control and Prevention and the American Dental Association, but a more specific response is required for the safe practice of oral and maxillofacial radiology. We aim to review the current knowledge of how the disease threatens patients and DHCPs and how to determine which patients are likely to be SARS-CoV-2 infected; consider how the use of personal protective equipment and infection control measures based on current best practices and science can reduce the risk of disease transmission during radiologic procedures; and examine how intraoral radiography, with its potentially greater risk of spreading the disease, might be replaced by extraoral radiographic techniques for certain diagnostic tasks. This is complemented by a flowchart that can be displayed in all dental offices.

Dental radiographic procedures during COVID-19 outbreak and normalization period: recommendations on infection control

Dental professionals have always been meticulous about infection control due to high risk of cross-contamination during dental procedures. Nevertheless, there is an urgent need to review and revise our current practice of infection control and develop more strict protocols that will prevent nosocomial spread of infection during COVID-19 outbreak and future pandemics. The risk of contamination is high during dental radiography if proper disinfection techniques are not applied. This document provides advice and guidance for infection control when practicing dental radiography during COVID-19 pandemic.

Turkish adaptation and implementation of the modified infection control questionnaire in intraoral digital imaging

Purpose

There are very few studies evaluating the knowledge of dentists about infection precautions in oral radiology. The aim of this study was to assess the psychometric properties of the Turkish version of the modified form of a developed questionnaire and to apply this questionnaire to Turkish dentists.

Materials and methods

The questionnaire was applied to a sample of 250 dentists for the scale development [200 for confirmatory factor analysis (CFA) and 50 for control] and 173 dentists for the implementation of the scale. The scale was applied to 200 dentists and construct validity was examined with CFA. For model fit; chi square to df ratio, RMSEA (Root Mean Square Error of Approximation), TLI (Tucker-Lewis Index), CFI (Comparative Fit Index), GFI (goodness of fit index), AGFI (adjusted goodness of fit index) and NFI (normed fit index) were obtained. Also, reliability analysis was applied and itemtotal correlations and Cronbach's alpha values were given. Adapted scale scores using a different sample of 173 dentists were compared according to demographic characteristics.

Results

CFA showed good fit statistics (X2/df=1.511, RMSEA=0.057, TLI=0.942, CFI=0.953, GFI=0.926, AGFI=0.900, NFI=0.928) for the scale. Item-total correlations were over 0.30 and Cronbach's alpha was calculated as 0.877. In addition, experienced dentists had higher scores in the dimension of personal hygiene (p<0.05).

Conclusion

The Turkish version of the modified infection control questionnaire in oral radiology showed adequate psychometric properties. This indicated that it could be a valid and reliable tool for the assessment of infection control in oral radiology among Turkish dentists.

Cross-contamination and infection control in intraoral digital imaging: a comprehensive review

Dental health care workers are subjected to various infectious disease agents that are present in patients' saliva and blood which make infection control and universal prevention methods indispensable to the dental practice given that some of these diseases cause loss of work and time for dental staff and patients; some of them cause serious morbidity; and some of them currently have a poor prognosis and no effective treatments. Although dental radiographic procedures are not invasive, and there are no incidents such as injuries caused by dental instruments, they are a potential infection source because of contamination with saliva and blood, and comprehensive infection control procedures also apply to the radiology clinic. In addition, contact with a large number of patients in dental schools and clinics in a short period of time, and the fact that radiographic procedures are performed in the same environment as other dental procedures in dental offices increase the significance of infection control in dental radiology. Major advances in computer technology have enabled digital imaging systems to develop rapidly and to become common in dental practice as an alternative to conventional film-based imaging. The use of digital sensors in dental radiology introduced unique infection control challenges and required the revision and modification of existing infection control techniques. In this review, studies concerning the risk of cross-contamination and challenges of infection control with digital image sensors are comprehensively reviewed and infection control protocols that should be followed in intraoral digital imaging using both direct and indirect systems are thoroughly examined.

A pilot study of the effects of a vacuum sealing barrier method for photostimulable phosphor plates regarding plate damage and prevention of microbiologic cross-contamination

OBJECTIVE

The aim of this study was to evaluate the effectiveness of a new sealing method for preventing cross-contamination of photostimulable phosphor (PSP) plates.

STUDY DESIGN

Twelve new PSP plates were divided into 3 groups (PSP-a, PSP-b, and PSP- c) and placed in 3 different barriers (2 different brands of envelopes and a vacuum sealing method). All plates were exposed to X-rays with an aluminum step wedge, and the images were evaluated for the presence of any artifacts. After radiography, the PSP plates were removed from the barriers. The barriers and the PSP plates were disinfected and culture performed to assess any microorganism burden. Subsequently, the PSP plates were coated again with all barriers. The barriers were then contaminated and microbiologic specimens were collected. Subsequently, the barriers were wiped with alcohol. The PSP plates were removed, and microbiologic specimens were obtained.

RESULTS

No artifacts were recorded on the radiographic images on the sensors in any group. Microorganisms were detected on the PSP plates placed in envelopes. No colonization of microorganisms was detected on the vacuum sealed PSP plates.

CONCLUSIONS

The new vacuum-sealing method may be useful in preventing cross-contamination of PSP plates during radiographic procedures.

The assessment of adherence to infection control in oral radiology using newly developed and validated questionnaire (QICOR)

OBJECTIVES:

To assess the infection control in oral radiology among radiologists and dentists of diverse dentistry clinical specialties and among dentistry students.

METHODS:

A Questionnaire on Infection Control in Oral Radiology was applied to 1006 dentists and 1203 dentistry students. For assessment of infection control, the scores of the questionnaire were dichotomized in high and low through the median. Simple logistic regression models were set for adherence to infection control and independent variables, estimating the crude odds ratios with the respective 95% confidence intervals. The variables with p < 0.20 in the individual analyses were tested in multiple logistic regression models, remaining in the final model the variables with p ≤ 0.05.

RESULTS:

Individual and adjusted association analysis showed that female dentists have 1.41 ([95% CI: 1.08-1.84)] more adherence odds to infection control when compared with males (p < 0.05). There was no significant association in regarding age, time of education in dentistry, an undergraduate degree from a public or private school, and work in public and/or private clinics. There were also no differences among radiologists and dentists of other clinical specialties. The students from the last year of the dental schools had 1.7 [95% CI (1.13-2.57)] more chances of less adherence to infection control (p = 0.0001). There was no significant association with respect to sex, age and public or private schools.

CONCLUSIONS:

Educational procedures should be conducted in relation to infection control protocols in oral radiology, especially among male dentists, regardless clinic specialty, and among the students of the last year of the dental school.

Development and validation of a questionnaire to evaluate infection control in oral radiology

OBJECTIVES

To create and validate a questionnaire to evaluate infection control in oral radiology.

METHODS

The questionnaire was developed after review of the literature, which included published articles and the biosafety protocols available from healthcare agencies. The initial version of the questionnaire was composed of 14 multiple choice questions and was divided into 3 domains on handwashing, disinfection/protection of surfaces and disinfectant used. Content validity was assessed by two expert committees, which reviewed the content and scope of the questionnaire and the relevance of each item, respectively. Reliability was evaluated using test-retest and internal consistency methods with 115 undergraduate dentistry students. Construct validity was assessed using the known-groups technique and factor analysis. The known-groups technique involved 641 undergraduate dentistry students, 20 PhD students and 15 oral radiology professors. In the factor analysis, 3 radiology technicians also participated in addition to the 641 undergraduates, 20 PhD students and 15 oral radiology professors.

RESULTS

The content validity results were found to be satisfactory to excellent for the ordinal variables (intraclass correlation coefficient = 0.722-1.000) and good to great for the yes/no questions (kappa = 0.662-0.913) in terms of reliability and good internal consistency (Cronbach's alpha = 0.88). After a factor analysis, some questions were excluded, and the questions were grouped into new domains. Significant differences were observed between answers from different groups. The final version of the questionnaire was composed of nine domains.

CONCLUSIONS

The questionnaire created was found to exhibit good psychometric properties for assessing infection control in oral radiology.